Lucchini Alberto, Villa Marta, Giani Marco, Canzi Sabrina, Colombo Sara, Mapelli Elisa, Mariani Ilaria, Rezoagli Emanuele, Foti Giuseppe, Bellani Giacomo
Direction of Health and Social Professions, General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza, University of Milano-Bicocca, Italy.
Department of Emergency and Intensive Care, General Adult and Pediatric Intensive Care Unit Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Intensive Crit Care Nurs. 2025 Feb;86:103833. doi: 10.1016/j.iccn.2024.103833. Epub 2024 Sep 18.
Critically ill patients frequently encounter disruptions in their circadian rhythms in the intensive care unit (ICU) environment. New lighting systems have been developed to enhance daytime light levels and to promote circadian alignment.
To investigate the impact of implementing an innovative lighting technology that mimics natural light and reproduce the colour of the sky.
Prospective, observational, non-randomized comparative trial. ICU patients were exposed to either a cutting-edge lighting system based on new technology (intervention group) or a conventional lighting system using fluorescent bulbs (control group).
An Italian intensive care unit with ten beds and five windowless rooms, thereby denying access to natural light. Three rooms had new lighting technology.
The two groups were compared to assess the prevalence or absence of delirium and the need for sedatives during ICU stay. The secondary aim was to assess the presence of anxiety, depression, and post-traumatic stress disorder in patients at 3, 6, and 12 months after ICU discharge.
86 patients were included: 52 (60 %) in the intervention group and 34 (40 %) in the control group. Seventy-nine patients (82 %) were alive at ICU discharge. Fourteen patients (16 %) developed delirium (intervention group: n = 8 [15 %] vs. control group: n = 6 [18 %] in the control group, (P=0.781). The use of sedative drugs and neuromuscular blocking agents was similar in both the groups. No differences in the incidence of anxiety, depression, or post-traumatic stress disorders were observed among patients who underwent follow-up visits.
Compared to traditional fluorescent tube lighting, the innovative lighting system did not provide any significant benefit in reducing the frequency of delirium or the necessity for sedative medications.
A single intervention, the use of lights that mimic sunny light and the sky, did not result in a statistically significant reduction in the incidence of delirium. Delirium has a multifactorial aetiology, necessitating interventions that are multifaceted and address different domains.
重症患者在重症监护病房（ICU）环境中经常会出现昼夜节律紊乱。新型照明系统已被开发出来，以提高白天的光照水平并促进昼夜节律同步。
研究采用一种模仿自然光并再现天空颜色的创新照明技术的影响。
前瞻性、观察性、非随机对照试验。ICU患者被分为两组，一组暴露于基于新技术的前沿照明系统（干预组），另一组暴露于使用荧光灯泡的传统照明系统（对照组）。
意大利一家拥有十张床位和五个无窗病房的重症监护病房，因此患者无法接触到自然光。三个病房采用了新的照明技术。
比较两组患者在ICU住院期间谵妄的发生率或有无谵妄，以及使用镇静剂的必要性。次要目的是评估患者在ICU出院后3个月、6个月和12个月时焦虑、抑郁和创伤后应激障碍的情况。
共纳入86例患者，其中干预组52例（60%），对照组34例（40%）。79例患者（82%）在ICU出院时存活。14例患者（16%）发生谵妄（干预组：8例[15%]，对照组：6例[18%]，P = 0.781）。两组使用镇静药物和神经肌肉阻滞剂的情况相似。随访患者中焦虑、抑郁或创伤后应激障碍的发生率无差异。
与传统荧光灯管照明相比，创新照明系统在降低谵妄发生率或减少镇静药物使用必要性方面未提供任何显著益处。
单一干预措施，即使用模仿阳光和天空的灯光，并未使谵妄发生率在统计学上显著降低。谵妄有多种病因，需要多方面的干预措施来解决不同方面的问题。
